We never failed to fail…

A couple of days ago somewhere in our travels I happened to catch a few minutes of Rachael Ray’s show on the Food Network. On this particular episode Rachael was being her chirpy self, prattling on about one of her 30-minute meals when (I was only about half listening) I heard the words: low-carb. I tuned in a little more and realized that Rachael was making a low-carb 30-minute meal. As I watched, it slowly dawned on me that Rachael doesn’t have a clue as to what low-carb really means. She was making a dish that was pasta-based (not the low-carb variety) and was adding dried apricots and other fairly high-carb stuff here and there along the way. After watching the remainder of the show closely, I realized that Rachael’s idea of low-carb is to avoid bread and potatoes – everything else seemed to be okay. Then I figured that if Rachael doesn’t know any better and really believes she’s cooking low-carb, so must many other people.
If many other people are doing low-carb in the same way Rachael is, then they’re in for some bitter disappointment.
The whole idea brings to mind an article I wrote for the now-defunct Low Carb Living magazine a year or so ago. Here it is in its entirety. Copy it and give it to someone who believes he or she is truly on a low-carb diet.

We Never Failed to Fail

We never failed to fail; it was the easiest thing to do, so say Crosby, Stills and Nash in their terrific song Southern Cross. Unfortunately, multitudes of low-carb dieters today will be crying these same words if they’re not careful because low-carb diets, if followed in a half-hearted manner will fail, and the resultant regain of lost weight will be the easiest thing to do.

Recently the NPD Group, a marketing research company that provides information to industry, tracked the eating habits of 11,000 people who were cutting carbs as part of a strategy to lose weight. The results of this study found in the report Carbohydrate Consumption Patterns show that virtually none of the 11,000 subjects, and by extrapolation, few to none of the population at large represented by the study subjects, were cutting carbohydrate intake to a meaningful degree. Instead of the 20-50 grams of carbohydrate per day recommended by us in our book Protein Power or by Atkins, South Beach, Sugar Busters, etc. men were consuming an average of 145 carbs per day while women were eating around 109 grams per day. Although these carb-consumption figures are less than the 210 grams of carbohydrate eaten by the non-low-carb dieter, they are not nearly low enough to bring about the benefits of low-carb dieting. We fear that the people making a modest stab at lowering carbohydrate intake are in for major disappointment.

Low-carb diets bring about a host of positive changes. Along with ditching excess fat followers of sound low-carbohydrate regimens see their triglycerides fall, their blood pressures normalize, their lipid profiles improve, and their blood sugar levels stabilize. They sleep better, get rid of bad indigestion, even GERD if they have it, have more energy and are much, much less hungry. And, seemingly magically, low-carb dieters can even consume more calories than their brethren on low-fat diets and lose more weight. But, and here’s the big but: low carb diets must be followed correctly to bring about all these benefits. If not, there is no magic.

Most cells in the body can use glucose or fat or even protein, for that matter, for energy, but certain cells can use glucose only. Those glucose-only cells are some of the cells in the brain, the red blood cells, cells in the kidney and cells in the retina. All these glucose-using cells consume about 120-150 grams of glucose per day (about 3/4 of a cup), so if we’re eating 210 grams of carbohydrate per day as the Carbohydrate Consumption Report shows, then we have plenty of glucose (most carbohydrates convert to glucose in the body) to feed them with 60-90grams left over. As long as we’re getting the carbohydrate in our diet to meet the needs of these glucose-only cells, then nothing much happens metabolically. If we get these carbs and more and eat a lot of calories, we gain weight; if we get these carbs, but cut our calories, then we can lose a little. But we have no low-carb magic. It’s only when we get the carbs significantly down below the 120-150 grams we need that the metabolic changes that make low-carb diets work kick in. But, you may be wondering, what about all those cells that have to have glucose? What happens to then when we cut our carbs way back? Let’s take a look.

Over the time we’ve been on earth as humans nature has endowed us with some pretty amazing metabolic protective features. Many times in our evolutionary history, in fact, during most of it, we probably didn’t get much more than 50 or 60 grams of carbohydrate per day, if that many. Most of the cells in our bodies respond to this carbohydrate restriction by kicking the sugar habit (for at least as long as there is no sugar around) looking to fat for their energy. Other cells, particularly the brain cells, learn to love ketone bodies; in fact ketone bodies become a substitute for glucose for the brain. The heart also uses ketone bodies, and, in fact, uses them much more efficiently than it does either glucose or fat. This switch from glucose to ketone bodies and fat leaves the small amount of ingested carbohydrate for the cells that absolutely have to have it. But, a sound low-carbohydrate diet restricts the carbohydrate intake to the point that even with the switch over to fat and ketone bodies for fuel there still isn’t enough incoming carbohydrate to meet the needs of all the glucose-dependent cells.

Not to worry, the body can make glucose from protein and, to a small extent, even from fat in a process called gluconeogenesis (making new sugar) that takes place in the liver. In fact, when it gets going the liver can crank out 200+ grams per day (a little over a cup), which is more than enough for all the glucose-dependent cells even if we weren’t eating any carbs at all. This ability of the liver to make plenty of sugar is what allows the Inuit, the Masai, and other groups of hunter populations to survive nicely for most of their lives on almost no carbohydrates at all. And it is this same ability that makes low-carb diets work as well as they do.

When the carbs quit coming in, blood sugar starts to fall slightly, which throws the switch for the whole sugar conserving process to begin. Insulin levels fall and glucagon levels rise, sending the signal to the liver to start making both ketone bodies and glucose. As the ratio of insulin to glucagon falls the fat cells (the very ones we want to get rid of) start releasing fat to be used by all the tissues switching to a higher-fat, lower-glucose diet and to be used by the liver to convert to the glucose-pinch-hitting ketone bodies. It takes more energy to convert either fat or protein to glucose then to burn the glucose than it does to burn the fat or protein directly. It is this extra energy-consuming step that increases the number of calories a low-carbohydrate diet burns.

As long as the carbohydrate restriction is in place, insulin levels stay low so that all these glucose-preserving and glucose-making processes continue because these metabolic processes can’t take place when insulin is high. And since elevated insulin levels are a driving force behind high blood pressure, elevated triglycerides, lowered good cholesterol, glucose intolerance and all the rest of the problems associated with obesity, then lowering these elevated insulin levels undoes all these problems. But to get the insulin levels down and bring about all these benefits you’ve got to get your carb intake down to significantly below the 120-150 grams per day required by the glucose dependent cells. That’s why all the 11,000 people who think they are on low carb diets while consuming an average of 145 grams of carbohydrate per day will “never fail to fail” because it is indeed “the easiest thing to do” when you don’t keep your carbs low enough.

We and all the other authors of low-carbohydrate plans recommend that dieters reduce their carb consumption to the 20-50 grams per day level. We do that because we’ve all learned that the low-carb diet works at those levels, and now you know why. If you pussyfoot around with your carb restriction, you’ll go nowhere; if you commit, then you’ll bring all the wonderful metabolic pathways nature has endowed you with into play and you will experience the low-carb magic.